{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:08:57Z","timestamp":1772042937082,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite multiple published reviews, the optimum method of correction and stabilisation of Blount\u2019s disease remains controversial. The purpose of this study is to evaluate the clinical and radiological outcomes of acute correction of late-onset tibial vara by percutaneous proximal tibial osteotomy with circular external fixation using two simple rings. Weighing up the pros and cons and to establish if this method would be the method of choice in similar severe cases especially in a context of limited resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted between November 2016 and July 2020. We retrospectively reviewed the clinical notes and radiographs of 30 patients (32 tibiae) who had correction of severe late-onset tibia vara by proximal tibial osteotomy and Ilizarov external fixator. The mean age at the time of the operation was 16.6 (\u00b1\u20092.7) years (range 13\u201322).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean proximal tibial angle was 65.7\u00b0 (\u00b1\u20097.8) preoperatively and 89.8\u00b0 (\u00b1\u20091.7) postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean mechanical axis deviation improved from 56.2 (\u00b1\u20098.3) preoperatively to 2.8 (\u00b1\u20091.6) mm postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean femoral-tibial shaft angle was changed from \u201334.3\u00b0 (\u00b1\u20096.7) preoperatively to 5.7\u00b0 (\u00b1\u20092.8) after correction, with degree of correction ranging from 25\u00b0 to 45\u00b0. Complications included overcorrection (three cases 9%) and pin tract infection (eight cases 25%). The mean Hospital for Special Surgery knee scoring system (HSS) improved from 51.03 (\u00b1\u200911.24) preoperatively to 94.2 (\u00b1\u20096.8) postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean length of follow up period 33.22 (\u00b1\u20096.77) months, (rang: 25\u201346\u2009months). At final follow up, all patients had full knee range of motion and normal function. All cases progressed to union and there were no cases of recurrence of deformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This simple procedure provides secure fixation allowing early weight bearing and early return to function. It can be used in the context of health care systems with limited resources. It has a relatively low complication rate. Our results suggest that acute correction and simple circular frame fixation is an excellent treatment choice for cases of late-onset tibia vara, especially in severe deformities.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12891-021-04496-y","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T10:03:43Z","timestamp":1628762623000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Acute correction of severe complex adolescent late-onset tibia vara by minimally invasive osteotomy and simple circular fixation: a case series with 2-year minimum follow-up"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3281-2698","authenticated-orcid":false,"given":"Abo Bakr","family":"Zein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4427-3871","authenticated-orcid":false,"given":"Ahmed S.","family":"Elhalawany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard R.","family":"Cousins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"4496_CR1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/00003086-199006000-00004","volume":"255","author":"GH Thompson","year":"1990","unstructured":"Thompson GH, Carter JR. 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CU.MD-213\u20132016\/21). Administrative permission to data access and use was received. Informed consent to participate: Written informed consent was obtained from both parents or legal guardians and the patients (if\u2009\u2265\u200916\u2009years old) who participated in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patients gave written consent for their personal or clinical details along with any identifying images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"681"}}